Abstract
A 34-year-old female had experienced head and hand tremors with a dystonic component for 8 months. Brain MRI showed T2 high signal intensity in the periaqueductal region, dorsal midbrain and dorsal upper pons. No abnormal uptake was noted on Tc-99m HMPAO SPECT or F-18 FP-CIT PET/CT. Wilson disease was diagnosed according to the 2008 consensus guideline from the American Association for the Study of Liver Disease and 2012 guideline from the European Association for the Study of the Liver. This case demonstrates T2 signal change in the basal ganglia, excluding the putamen, in a Wilson disease patient with relatively severe clinical findings, but normal Tc-99m HMPAO SPECT and F-18 FP-CIT PET/CT.
References
Roberts EA, Schilsky ML. Diagnosis and treatment of Wilson disease: an update. Hepatology. 2008;47:2089–111.
EASL Clinical Practice Guidelines: Wilson’s disease. J Hepatol. 2012;56:671–85.
van Wassenaer-van Hall HN, van den Heuvel AG, Algra A, Hoogenraad TU, Mali WP. Wilson disease: findings at MR imaging and CT of the brain with clinical correlation. Radiology. 1996;198:531–6.
Saatci I, Topcu M, Baltaoglu FF, Köse G, Yalaz K, Renda Y, et al. Cranial MR findings in Wilson’s disease. Acta Radiol. 1997;38:250–8.
Schlaug G, Hefter H, Engelbrecht V, Kuwert T, Arnold S, Stöcklin G, et al. Neurological impairment and recovery in Wilson’s disease: evidence from PET and MRI. J Neurol Sci. 1996;136:129–39.
Pujol A, Pujol J, Graus F, Rimola A, Peri J, Mercader JM, et al. Hyperintense globus pallidus on T1-weighted MRI in cirrhotic patients is associated with severity of liver failure. Neurology. 1993;43:65–9.
Jeon B, Kim JM, Jeong JM, Kim KM, Chang YS, Lee DS, et al. Dopamine transporter imaging with [123I]-beta-CIT demonstrates presynaptic nigrostriatal dopaminergic damage in Wilson’s disease. J Neurol Neurosurg Psychiatry. 1998;65:60–4.
Piga M, Murru A, Satta L, Serra A, Sias A, Loi G, et al. Brain MRI and SPECT in the diagnosis of early neurological involvement in Wilson’s disease. Eur J Nucl Med Mol Imaging. 2008;35:716–24.
Barthel H, Hermann W, Kluge R, Hesse S, Collingridge DR, Wagner A, et al. Concordant pre- and postsynaptic deficits of dopaminergic neurotransmission in neurologic Wilson disease. AJNR Am J Neuroradiol. 2003;24:234–8.
Barthel H, Sorger D, Kühn HJ, Wagner A, Kluge R, Hermann W. Differential alteration of the nigrostriatal dopaminergic system in Wilson’s disease investigated with [123I]ss-CIT and high-resolution SPET. Eur J Nucl Med. 2001;28:1656–63.
Ethics Statement
This study was approved by the ethics committee in our hospital and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Conflict of Interest
Seungyoo Kim, In Uk Song, Yong An Chung, Eun Kyung Choi and Jin Kyoung Oh declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kim, S., Song, I.U., Chung, Y.A. et al. Brain MRI, Tc-99m HMPAO SPECT and F-18 FP-CIT PET/CT Findings in a Patient with Wilson Disease: A Case Report. Nucl Med Mol Imaging 48, 303–305 (2014). https://doi.org/10.1007/s13139-014-0290-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13139-014-0290-4